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Short report
Deprescribing in older patients with advanced cancer referred to palliative care
  1. Jorge Fernández-Fradejas1,
  2. Hilario Martínez-Barros1,
  3. Lourdes Rexach-Cano2,
  4. Ana María Álvarez-Díaz1 and
  5. Eva Delgado-Silveira1
  1. 1 Servicio de Farmacia, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
  2. 2 Unidad de Cuidados Paliativos, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
  1. Correspondence to Jorge Fernández-Fradejas; jffradejas{at}salud.madrid.org

Abstract

Objectives This study aimed to explore the prevalence of potentially inappropriate medications (PIMs) in a cohort of older adults with advanced cancer referred to palliative care. Secondary objectives were to describe the categories of identified PIMs and assess risk factors associated with their presence in this population.

Methods This retrospective, observational study evaluated patients with advanced cancer admitted to a tertiary university hospital in Madrid, Spain and referred to palliative care between 1 January 2020 and 30 June 2020. Demographic, clinical, and pharmacotherapeutic data were obtained from the electronic medical records and regional databases. PIMs were assessed using the Screening Tool of Older Persons Prescriptions in Frail adults (STOPPFrail) criteria, V1.

Results Among 123 patients (median age 80 years (IQR 73.5–87), 64.2% male), 74% presented at least one PIM according to the STOPPFrail criteria. The most common categories of inappropriate medications were lipid-lowering therapies, proton pump inhibitors, calcium supplements, and oral antidiabetics. The number of chronic comedications was significantly associated with PIM presence.

Conclusions Our study found a high prevalence of PIM among a cohort of older adults with advanced cancer and short life expectancy. This underlines the need for a comprehensive medication review to optimise pharmacotherapy in this population.

https://doi.org/10.1136/spcare-2024-004849

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    Footnotes

    • X @j_ffradejas

    • Contributors JF-F, HM-B, LR-C, and ED-S contributed to the study conception and design. JF-F and HM-B performed data collection and analysis. JF-F wrote the first draft of the manuscript and HM-B, LR-C, ED-S, and AMA-D commented on early versions of the manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.